Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Locomotor 2 > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

What are stressors of the musculoskeletal system

A

Trauma

  • Sports injuries
  • RTA’s
  • Overuse

Infection
- Bone and joint

Altered metabolism

  • Age related
  • Disease related

Neurological

  • Muscle spasticity
  • Muscle paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what joints can be replaced

A

All joints

  • Upper limb: shoulder / elbow / wrist / hand
  • Lower limb: hip / knee / ankle
  • Spine: disc replacements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the indications for joint replacement

A

Degenerative disease (e.g. osteoarthritis)

Inflammatory disease (e.g. rheumatoid arthritis)

Trauma (e.g. fracture neck of femur / fracture neck of humerus)

Tumour

Vascular disease (e.g. Avascular necrosis)

Revision of previously failed / worn out joint replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the three types of joint replacement

A

cemented

hybrid - cemented stem but acetabulum is uncemented

reverse hybrid - uncemented stem and cemented cup

uncemented

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

uncemented is more…

A

expensive but is now more common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how long do joints last

A

15-20 years

  • depends on type of replacement
  • type of materials used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is one of the most common surgical proceeder today

A

total hip replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

some joints will always require …

A

cemented

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name a difference between cemented and uncemented

A
  • Cemented = can get the person mobile the next day
  • uncemented.=. have to wait for the bone to grow into the porous part of the replacement joint therefore takes 4-6 weeks of non weight bearing on that joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

who is cemented better for

A
  • obese
  • elderly
  • people with osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what polymer is in cemented replacements

A

Cemented fixation uses an acrylic polymer
Poly(methyl methacrylate) (PMMA)
- can give prophylactic antibiotics to prevent infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

described cemented placement

A
  • both the bone and cement must lock together to make the insertion last
  • cement simply acts as a filler between the bone and the implant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe the uncemented replacement

A

Uncemented have rough surface covered with porous or hydroxyapatite covering

Maximum bone ingrowth is obtained with pore size 100-200 μm

Gap should be <0.5mm to encourage bone growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe the benefit of using ceramic on ceramic as a new biomaterial

A
  • has least wear
  • less than 1 um a year -
  • fewer infections
  • more inert and less likely to start an immune reaction therefore less chance of aseptic loosening
  • but small rate of catastrophic failure - over stress ceramic can cause it to collapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe other biomaterials that can be used

A

ceramic on ceramic

Metal on metal

Ceramic in cross-linked polyethylene

Oxinium in cross-linked polyethylene

Metal in cross-linked polyethylene

  • 200μm a year
  • can lead to aseptic loosening

(listed in the wear and tear rate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what joint has the least wear rate

A

ceramic on ceramic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the indicators for spinal decompression surgery

A

Spinal stenosis

Damaged IV disc

Fractured vertebrae

Tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is spinal fusion and what is it for

A

Where 2 or more vertebrae are joined together with a section of bone to stabilise and strengthen the vertebral column
- won’t affect the movement of the vertebral column as the movement between two vertebra is quite small

19
Q

What can you use for spinal decompression surgery

A

bone graft

spinal fusion

IV disc replacement - allow rotational movement

inject bone cement in the centre of the vertebral body that will harden the vertebra

20
Q

what soft tissue treatments are there

A

Tendon repair

Tendon transfer

Tendon lengthening

Ligament repair

Ligament replacement

Free muscle transfer

21
Q

what are the options for tendon transfer for radial nerve palsy

A
  • PT to ECRB for wrist extension
  • FCU to EDC for finger MCP extension
  • PL to rerouted EPL for thumb extension
    Or
  • PT to ECRL and ECRB
  • FDS III to EDC
  • FDS IV to extensor indicis and EPL
  • FCR to APL and EPB
22
Q

what is tendon lenghting for

A
  • this is where you have hypertonia in muscle groups
    for example
  • For the lower limb one of the antagonist groups of muscles that are stronger than the other for example the quads are stronger than the hamstring and plantarflexors are stronger than dorsiflexors
    Hypertonic plantarflexors – end up toe walking, dorsiflexors cannot counteract it
23
Q

what can you use for ACL reconstructions

A

patellar ligament tibia graft,

  • goes down from the patellar down the patella ligament to the tibia tuberosity where it inserts, this is meant to heal in quicker as it is bone
  • tends to heal quicker

Hamstring

  • semitendinous overlies semimembranous therefore you can stitch the muscle to semimebranous underneath it and take the tendon part of semitendinous and use it for the ACL
  • gracilis tendon
24
Q

What is the unhappy triad

A

Medical mescius
ACL
Medial collateral ligament

25
Q

what are free muscle transfer

A

can use gracilis muscle and rectus femurs

26
Q

what muscles are used in free muscle transfer

A
  • gracilis or rectus femoris
  • or any muscle that is expendable (other muscles do its role)
  • under voluntary control
  • is superficial
27
Q

what can the gracilis muscle be used for

A

Deltoid reconstruction

Elbow flexion

Elbow extension

Finger flexion

Finger extension

28
Q

what is mal union

A

bone has healed but there is Misalignment of proximal and distal fragments leading to biomechanical deformity

29
Q

what can mal union lead to

A

Rotation
Angulation
Shortening
Translation

30
Q

what is delayed

A

Failure to consolidate within 1.5x the normal expected time

31
Q

What is non union

A

Failure to consolidate within 2x the normal expected time

32
Q

what happens in non union

A

Can be Atrophic / Hypertrophic depending on:

  • blood supply
  • degree of stability
33
Q

what can be used to treat a mal union

A

Osteotomy

- Re-alignment osteotomy

34
Q

What can be used to treat a shortened bone

A
  • Distraction osteogenesis

- progression correctvtion with use of an external fixator (e.g. Ilizarov technique)

35
Q

name 4 types of bone graft

A

Osteogensis
osteoconduction
osteoinduction
osteopromotion

36
Q

what is osteogenesis

A

Formation or development of new bone cells contained in graft

37
Q

what is osteoconduction

A

Physical effect by which the matrix of the graft forms a scaffold that favours outside cells to penetrate the graft and form new bone

38
Q

what is osteoinduction

A

Chemical process by which molecules contained in the graft convert the neighbouring cells into osteoblast

39
Q

what is osteopromotion

A

When the grafted material enhances osteoinduction

40
Q

define autograft

A

a tissue or organ that isgraftedinto a new position on the body of the individual from which it was removed.

41
Q

define allografts

A

a tissue or organ obtained from one member of a species andgraftedto a genetically dissimilar member of the same species.

42
Q

define xenografts

A

agraftobtained from a member of one species and transplanted to a member of another species.

43
Q

define alloplast

A

an inert foreign body used for transplantation into tissues.

44
Q

what rehabilitation takes place after orthopaedic surgery

A

Orthopaedic Physiotherapy

  • specialises in treating patients undergoing planned surgery
  • or those who are admitted to hospital due to a traumatic accident or incident

Locomotor 2 (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions